Pinched nerves

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technovelist
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Re: Pinched nerves

Post by technovelist » Sun Oct 18, 2020 3:38 pm

sophie wrote:
Sun Oct 18, 2020 12:51 pm
Sorry to hear about all the pain issues, guys....

A few general observations from your friendly neighborhood neurologist....

It's important to determine if the pain is neuropathic ("pinched nerve") or a muscle spasm. They're treated differently. Medication-wise, opiates for neuropathic pain makes the customer happy I'm sure, but it's not accepted practice and they don't work all that well. NSAIDs are tried first but generally won't work. The most effective drugs are an anti-epileptic like gabapentin or topiramate (lower doses than needed for epilepsy, which minimizes side effects). Pain will generally resolve with time depending on the cause...usually around 6 months but could take a couple years. If the pain isn't improving and can be traced to a definite site, surgery may be considered but get a second opinion and info on the possible outcomes from a neurologist first.

For muscle pain, heat/cold/NSAIDs are the first line, then trigger point injections. My favorite remedy: put an apple in the freezer and then lie down on it with the muscle knot right on the apple, and enjoy a nice glass of whiskey while you're at it. PT/stretching exercises help. So does a good massage therapist.

I get these too, I know how awful they can be. My sympathies.
Or a really good chiropractor, like ours in Dallas. The ones that professional athletes go to are usually pretty good.
Once when we were visiting him in his old office (10 years ago or so), we saw a short elderly man who looked familiar somehow.
It was Ross Perot.
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sophie
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Re: Pinched nerves

Post by sophie » Sun Oct 18, 2020 6:48 pm

Actually the best way to differentiate is to go by history (description of pain) and exam.

My money would be on the C6-7 disc. The shoulder blade pain was directly from the inflammation around the disc when it "popped" (so 3rd type of pain I guess). The numbness in the hand is the pinched nerve symptom (C6-7 mostly innervate the hands). So yeah, NSAIDs, steroids, and time (about 6 months). Take the NSAIDs round the clock (600 every 6 hours or 800 every 8 hours) they work much better that way.

Otherwise, your neck probably doesn't look too different from most people your age. Unfortunate that humans have a bit of a design flaw in the back and neck area.
pp4me
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Re: Pinched nerves

Post by pp4me » Tue Oct 20, 2020 7:50 am

Thanks for the free medical advice Sophie.

Having enjoyed excellent health for most of my life this experience has been kind of a blessing in disguise. It's teaching me to enjoy good days while you have them because they won't always be there.
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Re: Pinched nerves

Post by Mountaineer » Tue Oct 20, 2020 1:31 pm

pp4me wrote:
Tue Oct 20, 2020 7:50 am
Thanks for the free medical advice Sophie.

Having enjoyed excellent health for most of my life this experience has been kind of a blessing in disguise. It's teaching me to enjoy good days while you have them because they won't always be there.
Exactly. Entropy. And for what it's worth, Sophie's analysis was on target for me; one of my problems is NSAIDs give me severe nosebleeds so I could not follow all the advice she recommended. After reading her advice, I went back and reviewed the related doctor visits, MRI conclusions, PT conclusions for me. Sophie's analysis points out the importance of being truthful with your doctor, explaining all the little details that you may not think are of value, describe the symptoms well. If you desire a good diagnosis, give factual input. Helps the doctor be a bit more on target for you vs. just 'practicing' medicine. ;D
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